Anatomically relieved augments

ABSTRACT

Anatomically shaped augments that are configured for implantation in a bone and which have one or more reliefs. A distal end of an outer portion of the augment can have a shape that is configured to generally conform to the shape of a metaphyseal-diaphyseal junction of an intramedullary canal of a bone. A proximal end of the outer portion can have a shape that is configured to generally conform to a shape of the metaphyseal region of the intramedullary canal. The reliefs can be configured to reduce a size of the augment and enhance the degree of freedom in the implant positioning and/or sizing of the augment. Further, such reliefs may contour the augment so as to prevent cortical bone contact and/or prevent contact with the implant device that may be associated with misalignment between an intramedullary canal and metaphyseal or diaphyseal regions of the bone.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a continuation of pending U.S. patentapplication Ser. No. 16/216,437, filed Dec. 11, 2018, which is acontinuation of U.S. patent application Ser. No. 15/572,943 filed Nov.9, 2017, now abandoned, which is a U.S. National Phase of InternationalPCT Application No. PCT/US2016/032349 filed May 13, 2016, which claimsthe benefit of U.S. Provisional Application Ser. No. 62/160,891 filedMay 13, 2015, the contents of each application are incorporated hereinby reference in their entirety.

BACKGROUND

Embodiments of the present application generally relate to orthopedicaugments. More particularly, but not exclusively, embodiments of thepresent application relate to anatomically shaped orthopedic augmentsthat are configured to address unequal loading conditions and provideenhanced flexibility in placement within the associated bone canal.

Metaphyseal and/or diaphyseal augments typically assist in preventingloosening and/or subsidence of an articular implant/component, such as,for example, an implanted tibia baseplate. Such augments can helpdistribute loads exerted on or by the articular implant through thebone, with the articular component maintaining fixation, which canresult in a longer implant life.

One of the primary forces attributed to early failures of orthopedicimplants, particularly in the tibia, is torsional stress. Moreover,torsional stresses can shear the articular implant-bone interface(cemented or un-cemented) apart, which can facilitate premature or earlyfailure of the implant. Other forces, such as shear forces, can alsocontribute to similar premature or early failure of the articularimplant-bone interface. Additionally, compressive loads, particularlyunequal loads to a median plane (i.e. medial loading) of the articularimplant-bone interface, can also cause subsidence and early failures ofthe articular implant.

Additionally, too much cortical contact with the augment can, as aconsequence of carrying too much of the load, stress shield thearticular components of the bone interface. Such situations can resultin bone resorption, which can contribute to early failure of theimplant. Additionally, unequal cortical contact due to lack ofconformity or fit can load a particular region of the bone, and therebyrelieve the articular implant-bone interface in a similar region. In atleast certain situations, such unequal loads or contact can act as afulcrum, which can facilitate bone-interface failures for both theaugment and the articular implant.

BRIEF SUMMARY

An aspect of the present application is an augment for implantation inassociation with an orthopedic implant device in a bone, the augmenthaving an augment wall that includes an outer portion, an inner portion,a distal end, and a proximal end. The inner portion of the augment walldefines an inner region of the augment that is sized to receiveplacement of one or more components of the orthopedic implant device.The distal end at the outer portion has a first shape that is configuredto generally conform to the shape of a-metaphyseal-diaphyseal junctionof a canal of the bone. Additionally, the proximal end at the outerportion has a second shape that is configured to generally conform to ashape of the metaphyseal region of the canal of the bone. Further, thefirst shape has a different shape and size than the second shape. Theaugment further includes at least one relief that extends from at leastone of the proximal end or the distal end of the augment wall.Additionally, at least one relief is adapted to prevent, when theaugment is implanted in the bone, contact between a portion of theaugment wall and an adjacent wall of the bone.

BRIEF DESCRIPTION OF THE FIGURES

The description herein makes reference to the accompanying figureswherein like reference numerals refer to like parts throughout theseveral views.

FIG. 1 illustrates a medial-lateral view of a tibial articular implanthaving an anatomically relieved tibial augment according to anembodiment of the present application.

FIG. 2 illustrates a posterior-anterior view of the tibial implantdevice and anatomically relieved tibial augment shown in FIG. 1.

FIG. 3 illustrates an isometric view of an anatomically relieved tibialaugment according to an embodiment of the present application.

FIG. 4 illustrates a medial-lateral view of the anatomically relievedtibial augment shown in FIG. 3.

FIG. 5 illustrates a posterior-anterior view of the anatomicallyrelieved tibial augment shown in FIG. 3.

FIG. 6 illustrates a posterior-anterior view of a tibial implant deviceon a prepared implant bone.

FIG. 7 illustrates a cross sectional view, taken along line A-A of FIG.6, of the bone and tibial implant device, including the anatomicallyrelieved tibial augment.

FIG. 8 illustrates a posterior-anterior view of a femoral implant,device having an anatomically relieved femoral augment according to anembodiment of the present application.

FIG. 9 illustrates a medial-lateral view of the femoral implant deviceand anatomically relieved femoral augment shown in FIG. 8.

FIG. 10 illustrates an isometric view of an anatomically relievedfemoral augment according to an embodiment of the present application.

FIG. 11 illustrates a medial-lateral view of the anatomically relievedfemoral augment shown in FIG. 10.

FIG. 12 illustrates a posterior-anterior view of the anatomicallyrelieved femoral augment shown in FIG. 10.

FIG. 13 illustrates a medial-lateral view of a portion of an exemplaryfemoral implant device having an anatomically relieved femoral augmentpositioned on a prepared femoral bone.

FIG. 14 illustrates an anterior-posterior view of the portion of thefemoral implant device and the anatomically relieved femoral augmentshown in FIG. 13 positioned on the prepared femoral bone.

FIG. 15 illustrates a medial-lateral cross sectional view, taken alongline A-A of FIG. 14, of the portion of the femoral implant andanatomically relieved femoral augment on the prepared femoral bone.

The foregoing summary, as well as the following detailed description ofcertain embodiments of the present application, will be betterunderstood when read in conjunction with the appended drawings in whichlike reference numbers indicate like features, components and methodsteps. For the purpose of illustrating the invention, there is shown inthe drawings, certain embodiments. It should be understood, however,that the present invention is not limited to the arrangements andinstrumentalities shown in the attached drawings.

DETAILED DESCRIPTION

Certain terminology is used in the foregoing description for convenienceand is not intended to be limiting. Words such as “upper,” “lower,”“top,” “bottom,” “first,” and “second” designate directions in thedrawings to which reference is made. This terminology includes the wordsspecifically noted above, derivatives thereof, and words of similarimport. Additionally, the words “a” and “one” are defined as includingone or more of the referenced item unless specifically noted. The phrase“at least one of” followed by a list of two or more items, such as “A, Bor C,” means any individual one of A, B or C, as well as any combinationthereof.

FIGS. 1 and 2 illustrate medial-lateral and posterior-anterior views,respectively, of a tibial implant device 100 having an anatomicallyrelieved tibial augment 102 according to an embodiment of the presentapplication. In the depicted embodiment, the tibial implant device 100is a tibial articular assembly that includes a tibial (articular)baseplate 104, the tibial augment 102, and a stem 106. The stem 106,which can extend along a central stem axis 107, can be directly orindirectly coupled to the tibial baseplate 104, such as, for example,coupled to a tray stein 109 (FIG. 7). According to certain embodiments,the tibial implant device 100 can also include an offset/angled coupler,which can offset at least the central stem axis 107 relative to acentral tray stem axis 111 of the tray stem 109 of the base plate 104.The tibial implant device 100 can also include other components, suchas, for example, intramedullary stems and other augments that can beassembled to the tibial implant device 100.

The depicted tibial implant device 100 is structured to be cemented intoand through the tibial augment 102 and onto a prepared proximal tibia ofa patient. Further, while FIGS. 1 and 2 illustrate the tibial augment102 positioned on or about a tibial implant device 1.00 in anon-implanted state or condition, the tibial augment 102 can beimplanted in a bone of the patient prior to implantation of theremainder of the tibial implant device 100.

FIGS. 3-5 illustrate isometric, medial-lateral, and posterior-anteriorviews, respectively, an exemplary tibial augment 102 according tocertain embodiments of the present application. A variety of differentaugments can be used for the tibial augment 102, including, for example,a cone or sleeve augment, among other augments. Further, the tibialaugment 102 can have a variety of shapes and sizes. The tibial augment102 includes an augment wall 108 that has an inner portion 110 and anouter portion 112. The inner portion 110 of the augment wall 108 cangenerally define an inner region 114 of the tibial augment 102, whichcan extend between at least a portion of the distal and proximal ends116, 118 of the tibial augment 102. As indicated by at least FIGS. 1, 2,and 7, the inner portion 110 of the augment wall 108 can be sized toreceive passage and/or placement of at least a portion of the stem 106,a tray stem 109 of the baseplate 104, an offset/angled coupler, and/orother components of the tibial implant device 100 during implantation ofthe tibial implant device 100 in a patient.

The outer portion 112 of the tibial augment 102 can have a variety ofshapes and sizes. For example, according to certain embodiments, anaugment wall 108 of the tibial augment 102 can have a generallycylindrical or conical shape as the augment wall 108 extends between adistal end 116 and a proximal end 118 of the tibial augment 102.However, according to other embodiments, the augment wall 108 can beconstructed to generally conform to the shapes of different portions ofthe bone, such as, for example, the conical shape of the tibia bone,and/or to the shape of the inner wall of the intramedullary canal orprepared opening in the bone in which the tibial augment 102 will beimplanted. Thus, variations among and/or along at least the augment wall108 of the tibial augment 102 that accommodate such shapes of the bone,intramedullary canal, and/or the prepared opening can enhance theflexibility in the placement of the tibial augment 102 in the bone, andreduce or minimize the tibial augment 102 from hindering the ability toposition an associated articular component relative to a joint line,while also not hindering joint balance (flexion-extension balance) androtation of each component relative to the patella-femoral joint.Additionally, according to certain embodiments, the tibial augment 102can be symmetrical about at least one midline that is generallyperpendicular to a central augment axis 120 of the tibial augment 102.

To generally accommodate the cortical shape(s) of the tibia bone, theintramedullary canal of the tibia, and/or the shape of the preparedopening in the tibia bone in which the tibia augment 102 is to beimplanted, the shape of various portions or sides of the augment wall108 at the distal and/or proximal ends 116, 118, as well as the shapesof the sides of the augment wall 108 therebetween, can be differentand/or vary. According to such embodiments, such variances orinconsistencies among and/or along the sides or areas of the tibialaugment 102 can preclude the augment wall 108 of the tibial augment 102from having a generally uniform cylindrical or conical shape. Further,according to certain embodiments, the outer portion 112 of the augmentwall 108 of the tibial augment 102 can be configured such that at leastthe distal end 116, or diaphyseal end, of the tibial augment 102generally conforms to the general shape of the metaphyseal-diaphysealjunction of the tibia bone 122, and at least the proximal end 118 of thetibial augment 102 generally conforms to the general shape or profile ofthe metaphyseal region of the tibia bone 122. According to otherembodiments, the distal end 116 and/or proximal end 118 can be shaped toprovide other cross-sectional shapes that facilitate the ability of thetibial augment 102 to conform to the size and/or shape of at least aportion of the intramedullary canal 124 of the tibia bone 122 and/or ofthe prepared opening in the tibia bone 122. Such conforming of thetibial augment 102 may not be limited to the physical shape(s) of eachsection of the outer portion 112 of the tibial augment 102 mating ormatching the shape of the adjacent portion of the wall of theintramedullary canal 124, but instead can include being shaped tooperably align a central augment axis 120 of the tibial augment 102with, or at a selected position away from, a reference axis, including,for example, a longitudinal axis of the intramedullary canal 124, and/orthe central stem axis 107, among other reference axes. Additionally, theportion of the tibial augment 102 that is shaped to generally conform tothe shape or profile of the metaphyseal region can be located atdistance away, in the metaphyseal direction, from the portion of thetibial augment 102 that conforms to the general shape or profile of themetaphyseal-diaphyseal junction that is about the same as the distancebetween the metaphyseal region and metaphyseal-diaphyseal junction ofthe tibia bone 122.

As shown in at least FIGS. 1-5, according to certain embodiments, theaugment wall 108 can further include at least one opening 124 a, 124 bthat is configured to accommodate placement of a component of the tibialaugment 102. For example, according to the illustrated embodiment, thetibial augment 102 can include two openings 124 a, 124 b that are sizedto accommodate at least the passage and/or placement of at least aportion of the keel(s) 126 a, 126 b of the tibial baseplate 104.

The outer portion 112 of the augment wall 108 can also include one ormore reliefs 128 that are positioned at least around the distal end 116and/or the proximal end 118 of the tibial augment 102. According to theillustrated embodiment, the relief 128 can remove at least a portion ofthe augment wall 108 so as to reduce or otherwise alter the shape of atleast a profile of the tibial augment 102. For example, dashed lines inFIG. 3 illustrate a portion of the tibial augment 102 that can beremoved by the recess 128, and the resulting profile provided byinclusion of the relief 128. As discussed below, removing, altering,and/or contouring the shape and/or size of the tibial augment 102 viainclusion of one or more reliefs 128 that can increase the degree offreedom that can be attained in the placement and/or sizing of thetibial augment 102 in the tibia bone 122, intramedullary canal, and/or ashaped or prepared opening in the tibia bone 122.

According to certain embodiments, the recess 128 can be configured toextend through the augment wall 108 so as to include an aperture 130that exposes at least a portion of the inner region 114. Further, therelief 128 can also include one or more relief walls 132, such as, forexample, opposing sidewalls 136 a, 136 b and an upper wall 138 thatextends around the aperture 130. The relief walls 132 can reduce thethickness of the augment wall 108 at or around the aperture 130.Moreover, the augment wall 108 can have a material thickness between therelief wall 132 and the opposing inner portion 110 of the augment wall108 that is less than the thickness between opposing outer and innerportions 110, 112 of the augment wall 108.

The sidewalls 136 a, 136 b and upper wall 138 of the relief wall 132 canhave a variety of different shapes and orientations that can, in atleast certain situations, increase the degree of freedom in thepositioning and/or sizing of the tibial augment 102 in the bone 122 thatcan be attained via use of the relief 128. For example, in theillustrated embodiment, the upper wall 138 has a generally curved orarced shape, while the sidewalls 136 a, 136 b generally extend towardeach other from opposite directions before reaching the upper wall 138.Additionally, as shown in FIG. 3, according to the illustratedembodiment, the relief 128 can be configured such that a portion of therelief wall 132 has an angled or tapered profile that extends inwardlytoward the distal end 116, and which provides a larger or stepperincline than can have otherwise been provided by the augment wall 108without the inclusion of the relief 128 (as indicated by a comparison ofthe adjacent solid and dashed lines in FIG. 3).

FIGS. 4 and 5 illustrate a relief 128 having an aperture 130 thatextends through a portion of the distal end 116 of the tibial augment102, and a relief wall 132 that extends along a portion of the tibialaugment 102 and about the aperture 130. However, although the relief 128of the depicted embodiment includes an aperture 130 in the augment wall108, according to certain embodiments, the relief 128 can extend intothe augment wall 108 to a degree that prevents the formation of such anaperture 130 in the relief 128. Further, the aperture 130 of the relief128 and at least a portion of the relief wall 132 can extend along acentral relief axis 133 that is generally parallel to the adjacentportion of the augment wall 108 in which the aperture 130 is positioned.Further, the central relief axis 133 can be non-perpendicular to thecentral augment axis 120 and/or the central stem axis 133 that canextend into/through the inner region 114 of the tibial augment 102.

The degree to which the relief 128 extends along the augment wall 108can vary. For example, in the illustrated embodiment, the relief 128extends from the distal end 116 of the augment wall 108 to generally amid-region 134 of the augment wall 108, the mid region 134 being locateda midpoint or area between the distal and proximal ends 116, 118 of thetibial augment 102. Again, while the relief 128 depicted in FIGS. 4 and5 extends from the distal end 116 of the tibial augment 102, accordingto other embodiments, a relief, in addition to or in lieu of the relief128 depicted in FIGS. 4 and 5, can extend from the proximal end 118 ofthe tibial augment 102.

FIG. 7 provides an example of a relief 128 of a tibial augment 102 beingconfigured to accommodate the cortical shape and/or configuration of thetibia bone 122 and/or intramedullary canal, as depicted in FIG. 6. Asillustrated, the reduction in the size of the profile of at least aportion of the tibial augment 102, and, moreover, the resultingadjustment in the shape of the tibial augment 102, as provided by therelief 128, can be configured to at least assist in the tibial augment102 being anatomically shaped and/or to assist in contouring orotherwise shaping the tibial augment 102 avoid cortical bone contact,such as, for example, avoiding contact with the cortical bone in themetaphyseal-diaphyseal junction 140. Further, the relief 128 can besized or otherwise configured to prevent the tibial augment 102 fromengaging the asymmetric morphology of the tibia bone 122. Additionally,as also shown by FIG. 7, the inclusion of the relief 128 can at leastassist in the tibial augment 102 from avoiding contact with the implantconstruct, including, for example, contact with the tibial implantdevice 100 that can be associated with misalignment of theintramedullary canal with the metaphyseal and/or the diaphysealregion(s) of the tibia bone 122.

FIGS. 8 and 9 illustrate posterior-anterior and medial-lateral views,respectively, of a femoral implant device 200. The illustrated femoralimplant device 200 includes a femoral articular component 202, anintramedullary stem 206, and a femoral augment 206 according to anillustrated embodiment of the present application. The femoral implantdevice 200 can include other components, including, but not limited to,a distal augment and/or a posterior augment. The intramedullary stem206, which can extend along a central stem axis 208, can be directly orindirectly coupled to the femoral articular component 202, such as, forexample, coupled to a component stem of the femoral articular component202. According to certain embodiments, the femoral implant device 200can include an offset/angled coupler, which can offset at least thecentral stem axis 208 relative to an axis the component stem.

The depicted femoral implant device 200 is structured to be cementedinto and through the femoral augment 206 and onto a prepared distalfemur of a patient. Further, while FIGS. 8 and 9 illustrate the femoralaugment 206 positioned on or about a femoral implant device 200 in anon-implanted state or condition, the femoral augment 206 can beimplanted in a bone of the patient prior to implantation of theremainder of the femoral implant device 200. Thus, an inner region 219of the femoral augment 206 can be sized to receive passage and/orplacement of at least a portion of the intramedullary stem 206 and/orother components of the femoral implant device 200, including, forexample, an offset/angled coupler and/or a component stem of the femoralarticular component 202, during implantation of the femoral implantdevice 200 in a patient.

FIGS. 10-12 illustrate an example of a femoral augment 206 according toan illustrated embodiment of the present application. A variety ofdifferent augments can be used for the femoral augment 206, including,for example, a cone or sleeve augment, among other augments. Further,the femoral augment 206 can have a variety of shapes and sizes. Thefemoral augment 206 can include an augment wall 212 that extends about acentral augment axis 214 of the femoral augment 206. The augment wall212 has an inner portion 216 and an outer portion 218. The inner portion216 of the augment wall 212 can generally define an inner region 219 ofthe femoral augment 206. At least a portion of the inner region 219 canextend between a distal end 220 and a proximal end 222 of the femoralaugment 206. The inner region 219 can be sized to receive placement ofat least one or more components of the femoral augment 206, such as, forexample, the intramedullary stein 206, an offset/angled coupler, and/orthe component stem of the femoral articular component 202, and junctionsthere between, among other components.

The outer portion 218 of the augment wall 212 can be shaped to generallyfit the cortical shape of a distal femur and/or a portion of theintramedullary canal of the femur. Thus, according to certainembodiments, a diaphyseal or distal end 220, of the femoral augment 206can be shaped to generally conform to the general shape of themetaphyseal-diaphyseal junction of femoral bone. Further, the opposingproximal end 222 of the femoral augment 206 can be configured togenerally conform to the general shape or profile of the metaphysealregion of the femoral bone. According to other embodiments, the distalend 220 and/or proximal end 222 can be shaped to provide othercross-sectional shapes that facilitate the ability of the femoralaugment 206 to conform to the size and/or shape of at least a portion ofthe femur and/or the intramedullary canal of the femur. Such conformingmay not be limited to the physical shape(s) of each section of the outerportion 218 of the augment mating or matching the shape of the adjacentportion of the inner wall of the intramedullary canal of the femoralbone, but instead can include being shaped to generally align with acentral augment axis 214 of the femoral augment 206, or at a selectedposition away from a reference axis, including, for example, alongitudinal axis of the intramedullary canal of the femur and/or thecentral stem axis 208, among other reference axes. Additionally, theportion, of the femoral augment 206 that is shaped to generally conformto the shape or profile of the metaphyseal region of the femur and/orthe intramedullary canal of the femur can be located at distance away,in the metaphyseal direction, from the portion of the femoral augment206 that conforms to the general shape or profile of themetaphyseal-diaphyseal junction that is about the same as the distancebetween the metaphyseal region and metaphyseal-diaphyseal junction ofthe femur.

To generally accommodate the cortical shape(s) of femur and/or themedullary canal of the femur, including, for example, the shape at boththe metaphyseal-diaphyseal junction and at metaphyseal region of thefemur, as well as shapes therebetween, different areas or sides of theouter portion 218 of the augment wall 212 can have different shapes.Additionally, the shapes along such different areas or sides of theouter portion 218 of the augment wall 212 can also vary between thedistal and proximal ends 220, 222 of the femoral augment 206. Suchvariances or inconsistencies among and/or along the sides or areas ofthe femoral augment 206 can preclude the augment wall 212 of the femoralaugment 206 from having a generally uniform cylindrical or conicalshape. However, according to other embodiments, the femoral augment 206can have a generally cylindrical or conical shape.

As shown by at least FIGS. 10-12, the outer portion 218 of the augmentwall 212 can include one or more reliefs 224 a, 224 b that arepositioned at least around a portion of the distal end 220 and/or theproximal end 222 of the femoral augment 206. According to theillustrated embodiment, the reliefs 224 a, 224 b can provide a recessand/or aperture 226 a, 226 b in the augment wall 212, and a relief wall228 that reduces the thickness of the augment wall 212 at or around theapertures 226 a, 226 b. As shown in FIGS. 10-12, in the depictedembodiment, the femoral augment 206 includes a first relief 224 a thatextends from the distal end 220 and toward the proximal end 222 of thefemoral augment 206, and another, second relief 224 b on a generallyopposing side of the augment wall 212 that extends in an oppositedirection, and more specifically, extends from the proximal end 222toward the distal end 220 of the femoral augment 206. As illustrated, inthe depicted example, each relief 224 a, 224 b extends to an areaadjacent, or in relatively close proximity to, the opposing distal orproximal end 220, 222 of the augment 206.

The relief wall 228 for each relief 224 a, 224 b can extend along thefemoral augment 206 and at least about the aperture 226 a, 226 b.Further, the augment wall 212 can have a material thickness between therelief walls 228 and the inner portion 216 of the augment wall 212 thatis less than the thickness between opposing inner and outer portions216, 218 of the augment wall 212. Further, although the reliefs 224 a,224 b of the depicted embodiment each include an aperture 226 a, 226 bin the augment wall 212, according to certain embodiments, one or bothof the reliefs 224 a, 224 b can extend into the augment wall 212 to adegree that prevents the formation of such an aperture 226 a, 226 b.

According to the illustrated embodiment, the apertures 226 a, 226 band/or at least a portion of the relief walls 228 can extend along anassociated central relief axis 230 a, 230 b that is generally parallelto the adjacent portion of the augment wall 212 in which the apertures226 a, 226 b and/or relief walls 228 is/are positioned. Further, thecentral relief axes 230 a, 230 b can be non-perpendicular to the centralaugment axis 214 of the femoral augment 206 and/or to the central stemaxis 208 of the intramedullary stem 204 that can extend into/through theinner region 219 of the femoral augment 206.

As shown in FIGS. 10-12, according to the illustrated embodiment, therelief walls 228 of the reliefs 224 a, 224 b can each include opposingsidewalls 232 a, 232 b and an adjoining upper wall 234. The sidewalls232 a, 232 b and upper wall 234 can have a variety of different shapesand orientations that can, in at least certain situations, facilitatethe freedom of positioning and/or sizing that is attained via use of thereliefs 224 a, 224 b. For example, as shown by at least FIG. 11, in theillustrated embodiment, the upper wall 234 for the first relief 224 acan have a generally curved or arced shape, while the upper wall 234 ofthe second relief 224 b includes a generally flat section 236. Further,as shown in at least FIG. 12, at least a portion of the sidewalls 232 a,232 b of the reliefs 224 a, 224 b can have angled or tapered profilesthat extend inwardly toward the associated distal end 220 or proximalend 222, which can assist in providing the femoral augment 206 with anarrower or thinner profile in those regions than would be provided inthe absence of the reliefs 224 a, 224 b (as indicated by the dashedlines in FIG. 12).

The anatomical shape of the tibial or femoral augments 102, 206, as wellas the inclusion of the reliefs 128, 224 a, 224 b, can increase theavailable choices or freedom in the positioning and/or sizing of theaugments 102, 206 in the corresponding prepared tibial or femur bone, orshaped opening in the tibial or femur bone and/or the associatedintramedullary canal in which the tibial or femoral augment 102, 206 isimplanted. As discussed, the inclusion of the reliefs 128, 224 a, 224 bcan reduce the profile and/or size of the tibial femoral augment 102,206 at least at the distal end 116, 220 and proximal end 118, 222,and/or along the opposing sides of the tibial or femoral augment 102,206. Further, the reliefs 128, 224 a, 224 b can be configured such thatthe augments 102, 206 are configured to accommodate certaincharacteristics in the shape of the bone or bone canal in which theaugments 102, 206 can be placed. For example, the inclusion of thereliefs 128, 224 a, 224 b can at least assist in the augments 102, 206avoiding contact with certain portions of the bone, such as, forexample, preventing the femoral augment 206 from engaging the asymmetricmorphology of the femur.

When an anatomically shaped tibial or femoral augment 102, 206 thatincludes a relief(s) 128, 224 a, 224 b, as discussed herein, issubjected to placement at relatively shallow depths in the shaped orprepared tibial or femur, such as when an implant device 100, 200 isnear the epiphysis of the bone, cancellous bone can be the primary, andpossibly only, contact to the load bearing surfaces of the tibial orfemoral augment 102, 206. Further, as the depth of the prepared openingin the tibial or femoral bone increases conformity, proximity of theprepared opening and placement of the anatomically shaped augments 102,206 having the reliefs 128, 224 a, 224 b to the cortical bone can alsoincrease. Such conformity and consistency of cancellous and/or corticalbone contact throughout a depth variation of deployment of the tibial orfemoral augments 102, 206 can at least assist in enhancing the evennessin load distribution, as well as enhance resistance implant failure,that can otherwise be attributed to loosening and/or subsiding due toone or more of the forces, such as, for example, compressive, shear,and/or torsion forces, that can be associated with implant devices andassociated components. Accordingly, the anatomically shaped tibial andfemoral augment augments 102, 206 can be configured, including shapedand/or via the inclusion of reliefs 128, 224 a, 224 b, to prevent orminimize the occurrence of point contact between the augments 102, 206and the adjacent cortical wall of the bone. The prevention of such pointcontact can include preventing misaligned or unequal circumferentialload sharing about the cortical wall. Further, by preventing pointcontact, the augments 102, 206 can prevent or otherwise minimize thepotential for the augment 102, 206 to penetrate through, or otherwiseviolate, the adjacent conical wall of the bone.

Shaping the tibial and femoral augments 102, 206 to generally conformto, or accommodate, changes and/or variances in the shape of the tibiaand femoral bone, respectively, and/or the intramedullary canal 124 ofthose bones, can prevent or minimize the extent to which the tibial orfemoral augments 102, 206 are subjected to unequal loading conditions.Further, by shaping different portions or areas of the tibial andfemoral augments 102, 206 to generally conform to or otherwiseaccommodate the shape of at least an adjacent inner wall of theassociated bone canal or cavity, the generally anatomically shapedaugments 102, 206 discussed herein can reduce the impact forces on thecorresponding articular implant-bone interface by distributing suchforces or loads over a relatively larger surface area. Morespecifically, for example, such conforming configurations of theaugments 102, 206 can improve resistance to torsional stress by equallydistributing such forces circumferentially.

FIGS. 13 and 14 illustrate medial-lateral and anterior-posterior views,respectively, of a femoral articular component 202 of an exemplaryfemoral implant device 202 having an anatomically relieved femoralaugment 206, and which is positioned on a prepared femoral bone 240.Further, FIG. 15 illustrates a medial-lateral cross sectional view ofthe portion of the femoral articular component 202 and the anatomicallyrelieved femoral augment 206 on the prepared femoral bone 240, as takenalong line A-A of FIG. 14. As shown in FIG. 13, a first relief 224 a canbe configured to generally conform the shape or profile of the femoralaugment 206 to the shape of the femoral bone 240 at themetaphyseal-diaphyseal junction 242, and moreover, to avoid contact withthe cortical bone in the metaphyseal-diaphyseal junction 242. Further,as shown, the inclusion of the reliefs 224 a, 224 b can at least assistin the femoral augment 206 avoiding contact with the implant construct,including, for example, contact with the femoral articular component 202that can be associated with intramedullary canal misalignment with themetaphyseal and/or the diaphyseal region(s) of the femoral bone 240. Forexample; as shown, the second relief 224 b of the femoral augment 206can be shaped to prevent or otherwise minimize the femoral augment 206from contacting an inner portion 216 of the femoral implant device 200,such as, for example, an inner portion of the articular implantconstruct, while still providing a segment of the femoral augment 206 atthe distal end 220 of the femoral bone 240 that can be implanted at apositioned in a prepared portion or cavity of the bone 240. Thus, thereliefs 224 a, 224 b, as illustrated, can be constructed to allow for adegree of rotational freedom in the angular position of the implantedfemoral augment 206 about at least the central augment axis 214 whilestill allowing the femoral augment 206 to generally conform to the shapeof the femoral bone 240 and still prevent, if desired, contact betweenthe femoral augment 206 and the inner portion 216 of the femoral implantdevice 200.

While the invention has been described in connection with what ispresently considered to be the most practical and preferred embodiment,it is to be understood that the invention is not to be limited to thedisclosed embodiment(s), but on the contrary, is intended to covervarious modifications and equivalent arrangements included within thespirit and scope of the appended claims, which scope is to be accordedthe broadest interpretation so as to encompass all such modificationsand equivalent structures as permitted under the law. Furthermore itshould be understood that while the use of the word preferable,preferably, or preferred in the description above indicates that featureso described may be more desirable, it nonetheless may not be necessaryand any embodiment lacking the same may be contemplated as within thescope of the invention, that scope being defined by the claims thatfollow. In reading the claims it is intended that when words such as“a,” “an,” “at least one” and “at least a portion” are used, there is nointention to limit the claim to only one item unless specifically statedto the contrary in the claim. Further, when the language “at least aportion” and/or “a portion” is used the item may include a portionand/or the entire item unless specifically stated to the contrary.

1. A tibial implant comprising: a tibial baseplate including a topsurface and a bottom surface; a stem extending from the bottom surface;and an augment arranged and configured to receive the stem therethrough,the augment including: an augment wall having an outer portion, an innerportion, an anterior side, a posterior side, a distal most end, and aproximal most end opposite the distal most end, the inner portiondefining an inner region of the augment, the inner region sized toreceive the stem so that the proximal most end of the augment wall ispositioned adjacent to the bottom surface of the tibial baseplate inuse, the inner region extending along a longitudinal axis; and a reliefformed in the augment wall and extending through the augment wall fromthe outer portion to the inner portion, the relief extending from thedistal most end toward the proximal most end and along a relief axis. 2.The tibial implant of claim 1, wherein the relief axis is oblique to thelongitudinal axis and extends away from the longitudinal axis in adistal-to-proximal direction.
 3. The tibial implant of claim 1, whereinthe outer portion is stepped.
 4. The tibial implant of claim 1, whereinthe relief further includes a relief wall, the relief wall beinginwardly tapered to reduce a profile size of the augment.
 5. The tibialimplant of claim 1, wherein the relief has a distal end portion and aproximal end portion, and wherein the distal end portion is wider thanthe proximal end portion.
 6. The tibial implant of claim 1, wherein therelief is formed in the posterior side of the augment wall.
 7. Thetibial implant of claim 1, wherein the relief terminates midway betweenthe distal most end and the proximal most end.
 8. The tibial implant ofclaim 1, further comprising a pair of openings extending distally fromthe proximal most end, wherein the pair of openings is configured toreceive placement of a pair of keels extending from the tibialbaseplate.
 9. The tibial implant of claim 1, wherein the anterior sideextends at a first angle relative to the longitudinal axis, wherein theposterior side extends at a second angle relative to the longitudinalaxis, and wherein the first angle is different from the second angle.10. The tibial implant of claim 1, further comprising a second reliefformed in the augment wall and extending through the augment wall fromthe outer portion to the inner portion, the second relief extending fromthe proximal most end toward the distal most end and along a secondrelief axis, wherein the second relief axis is oblique to thelongitudinal axis and extends away from the longitudinal axis in aproximal-to-distal direction.
 11. The tibial implant of claim 1, whereinthe second relief terminates midway between the proximal most end andthe distal most end.
 12. A femoral implant comprising: a femoralarticular component including an articular surface and a proximalsurface opposite the articular surface; a stem extending from theproximal surface; and an augment arranged and configured to receive thestem therethrough, the augment including: an augment wall having anouter portion, an inner portion, an anterior side, a posterior side, adistal most end, and a proximal most end opposite the distal most end,the inner portion defining an inner region of the augment, the innerregion sized to receive the stem so that the distal most end of theaugment wall is positioned adjacent to the proximal surface of thefemoral component in use, the inner region extending along alongitudinal axis; and a relief formed in the augment wall and extendingthrough the augment wall from the outer portion to the inner portion,the relief extending from the proximal most end toward the distal mostend and along a relief axis.
 13. The femoral implant of claim 12,wherein the relief axis is oblique to the longitudinal axis and extendsaway from the longitudinal axis in a proximal-to-distal direction. 14.The femoral implant of claim 12, wherein the outer portion is stepped.15. The femoral implant of claim 12, wherein the relief further includesa relief wall, the relief wall being inwardly tapered to reduce aprofile size of the augment.
 16. The femoral implant of claim 12,wherein the relief has a proximal end portion and a distal end portion,and wherein the proximal end portion is wider than the distal endportion.
 17. The femoral implant of claim 12, wherein the relief isformed in the posterior side of the augment wall.
 18. The femoralimplant of claim 12, wherein the relief terminates midway between theproximal most end and the distal most end.
 19. The femoral implant ofclaim 12, further comprising a pair of openings extending proximallyfrom the distal most end, wherein the pair of openings is configured toreceive placement of a pair of keels extending from the articularcomponent.
 20. The femoral implant of claim 12, wherein the anteriorside extends at a first angle relative to the longitudinal axis, whereinthe posterior side extends at a second angle relative to thelongitudinal axis, and wherein the first angle is different from thesecond angle.
 21. The femoral implant of claim 12, further comprising asecond relief formed in the augment wall and extending through theaugment wall from the outer portion to the inner portion, the secondrelief extending from the distal most end toward the proximal most endand along a second relief axis, wherein the second relief axis isoblique to the longitudinal axis and extends away from the longitudinalaxis in a distal-to-proximal direction.
 22. The femoral implant of claim12, wherein the second relief terminates midway between the distal mostend and the proximal most end.